title: Perceptions regarding oral rehydration solutions for the management of diarrhea in Guatemalan children: implications for diarrheal management in the Americas.
abstract: OBJECTIVE
  To describe knowledge and perceptions regarding the use of oral rehydration solution (ORS) for the management of diarrheal diseases among formal and informal health care providers and community caregivers in the Guatemalan department of Santa Rosa, and to recommend strategies to increase ORS use for management of diarrhea in children.
  
  
  METHODS
  From July to September 2008, in-depth, semi-structured interviews were conducted with formal health care providers; open-ended interviews were conducted with informal health care providers; and focus group discussions and pile sorting were carried out with community caregivers.
  
  
  RESULTS
  The study participants attributed episodes of diarrhea in children to culturally recognized or folk ailments (empacho, cuajo, and varillas) that are primarily treated by traditional healers. There were knowledge deficits about 1) dehydration as a manifestation of diarrhea, and 2) management of dehydration, including the use of ORS and the need to continue feedings during diarrheal episodes. Caregivers perceived bottled/ready-made ORS products and the more expensive over-the-counter antidiarrheal medications as superior to ORS packets in the treatment of diarrhea.
  
  
  CONCLUSIONS
  In Guatemala, folk etiologies of disease differ from those of the biomedical establishment and influence the decisions made by caregivers when treating ill children, including those related to the use of ORS. Public health campaigns addressing the treatment and management of diarrheal diseases in Santa Rosa should recognize the ailments known as empacho, cuajo, and varillas and target them for ORS use by community caregivers as well as health care providers in both the formal and informal health sectors.
authors.affiliation: Centro de Estudios en Salud, Universidad del Valle de Guatemala, Guatemala City, Guatemala, dwi4@cdc.gov.
authors.forename: Wences
authors.initials: W
authors.lastname: Arvelo
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Degollado
authors.forename: Lissette
authors.initials: L
authors.lastname: Reyes
authors.forename: Andrés
authors.initials: A
authors.lastname: Álvarez
mesh_terms: D000293:Adolescent; D000328:Adult; D000930:Antidiarrheals / Q000627:therapeutic use; D001291:Attitude of Health Personnel; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D002675:Child, Preschool; D003469:Culture; D003681:Dehydration / Q000188:drug therapy / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D003967:Diarrhea / Q000150:complications / Q000401:mortality / Q000628:therapy*; D003968:Diarrhea, Infantile / Q000150:complications / Q000401:mortality / Q000628:therapy; D004522:Educational Status; D005260:Female; D005440:Fluid Therapy / Q000523:psychology*; D017144:Focus Groups; D006166:Guatemala / Q000453:epidemiology; D006282:Health Personnel / Q000523:psychology*; D006293:Health Promotion; D006801:Humans; D007223:Infant; D008297:Male; D008519:Medicine, Traditional / Q000523:psychology; D008875:Middle Aged; D004366:Nonprescription Drugs; D008517:Phytotherapy / Q000523:psychology / Q000706:statistics & numerical data; D036301:Qualitative Research; D015532:Rehydration Solutions / Q000627:therapeutic use*; D012494:Sampling Studies; D009626:Terminology as Topic; D055815:Young Adult
chemical_list: D000930:Antidiarrheals; D004366:Nonprescription Drugs; D015532:Rehydration Solutions